title: A rapidly enlarging neck mass: the role of the sitting position in fiberoptic bronchoscopy for difficult intubation.
abstract: Difficult airway management is a dilemma for any anesthesiologist. Although practice guidelines and algorithms may help in such situations, the anesthesiologist's judgment and vigilance remain the primary means to save lives. In the following case, we encountered an acutely enlarging thyroid mass that was compromising the airway. This huge neck mass precluded tracheostomy under local anesthesia, and the patient could breathe only in the sitting position. Therefore, there were few safe strategies for airway management for general anesthesia. We reiterate the role of awake fiberoptic intubation in such circumstances.
authors.affiliation: Department of Anesthesiology and Anesthesia Research Center, Shahid Beheshti University, M.C. Tehran, Iran. alidabbagh@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Dabbagh
authors.forename: Naseraddin
authors.initials: N
authors.lastname: Mobasseri
authors.forename: Hedayatollah
authors.initials: H
authors.lastname: Elyasi
authors.forename: Babak
authors.initials: B
authors.lastname: Gharaei
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Fathololumi
authors.forename: Mahshid
authors.initials: M
authors.lastname: Ghasemi
authors.forename: Iman Bandarchi
authors.initials: IB
authors.lastname: Chamkhale
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D001999:Bronchoscopy / Q000379:methods* / Q000592:standards*; D018450:Disease Progression; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods / Q000592:standards; D006801:Humans; D007440:Intubation / Q000379:methods* / Q000592:standards; D009333:Neck / Q000033:anatomy & histology*; D011187:Posture; D016683:Supine Position; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome